Exercise augments weight loss induced improvement in renal function in obese metabolic syndrome individuals

Straznicky, Nora E.; Grima, Mariee; Lambert, Elisabeth; Eikelis, Nina; Dawood, Tye; Lambert, Gavin W.; Nestel, Paul J.; Masuo, Kazuko; Sari, Carolina Ika; Chopra, Reena; Mariani, Justin A.; Schlaich, Markus P.

doi:10.1097/hjh.0b013e3283418875

Cited by 107 publications

(106 citation statements)

References 51 publications

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“…23 In addition, we reported in a recent study that WL might contribute to the improvement in renal function that accompanies suppression of muscle sympathetic nerve activity in obese subjects with metabolic syndrome. 30 In the present study, we observed that long-term WL, even mild or moderate, was associated with a reduction in sympathetic activity with concomitant improvement in renal function, as assessed from measures of serum creatinine and estimated CCr. Taken together, activation of the sympathetic nervous system is an important factor in the onset and development of obesity-related renal injury, 7,20,22,23 and hence WL Renal function during weight loss K Masuo et al programs should be initiated and convey some degree of renal protection in the overweight/obese patient.…”

Section: Discussionsupporting

confidence: 58%

“…Many large studies [24][25][26] have shown marked clinical benefits of lifestyle intervention, and modest WL, on the resolution of obesity-relate diseases including CKD as well as long-term benefits on all-cause mortality. In obese subjects, obesity-related glomerular hyperfiltration, 27 elevated sympathetic nervous activity, 12,13,[28][29][30] insulin resistance and stimulation of the renin-angiotensin-aldosterone system (RAS) 30,31 are ameliorated after WL.…”

Section: Introductionmentioning

confidence: 99%

“…34 However, only few investigators have simultaneously taken into account the sympathetic nervous activity and renal function in the same study population, followed longitudinally to evaluate the relationships of sympathetic nervous activity with renal function during WL with life-style modifications. 30,35 In the present study, using plasma NE levels as a marker of sympathetic activity we evaluated the role of the sympathetic nervous system on renal function (measured serum creatinine and CCr) during WL over a 12-month period with mild caloric restriction and exercise (life-style modification).…”

Section: Introductionmentioning

confidence: 99%

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Effects of weight loss on renal function in overweight Japanese men

et al. 2011

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Obesity is known as an independent risk factor for renal injury. Sympathetic nerve activation may have an important role of the pathogenesis of obesity, and hypertension may underpin the development of cardiovascular events. In the present study, we evaluated the effects of weight loss (WL) on renal function, especially focusing on sympathetic nervous activity. In 154 overweight or obese Japanese men (89 normotensive and 65 untreated mild hypertensive subjects), body weight, body mass index (BMI), total body fat mass, blood pressure (BP), serum creatinine, blood urea nitrogen, creatinine clearance (CCr) (calculated with the Cockcroft-Gault equation) and plasma norepinephrine (NE) were measured before and after a 12-month period of WL with a mild caloric-restricted diet and exercise. A significant WL was defined as 10% or more WL compared with the entry period. In total, 97 (63.0%) subjects succeeded in significant (by 14.3%) WL at 12 months, and 57 subjects (37.0%) did not succeed in significant WL but they lost 7.7% weight. At entry, levels of plasma NE, serum creatinine and fat mass were significantly lower and CCr was greater in the group with a significant WL compared with those without WL. BMI, total body fat mass and plasma NE significantly decreased, and CCr increased with WL. At both baseline and at the 12-month period, fat mass and plasma NE negatively correlated with CCr and positively correlated with creatinine at each time point. Changes in fat mass and plasma NE over 12 months correlated with changes in creatinine, and only changes in fat mass negatively correlated with changes in CCr. Basal fat mass and plasma NE correlated positively with serum creatinine at 12 months and negatively with CCr at the same time point. In multiple regression analyses, basal plasma NE and fat mass were significant determinants of serum creatinine levels and CCr at 12 months.In conclusion, WL improved renal function (as evident from measures of creatinine and CCr) in overweight individuals. Basal plasma NE levels and total body fat mass could be predictors for improvement in renal function associated with WL. Suppression of sympathetic nervous activation associated with WL may have a role in the ameliorative effects on renal function.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of weight loss on renal function in overweight Japanese men

et al. 2011

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“…Our recent study in obese Caucasian individuals with the metabolic syndrome demonstrated that exercise over 12 weeks had additional effects on weight loss and BP reduction and were associated with suppression of plasma renin activity compared with calorie restriction alone, whereas suppression of muscle sympathetic nervous activity was similar. 54 In another study, comparing the effects of exercise and a calorie restricted diet on sympathetic nervous activity, the addition of moderateintensity aerobic exercise training to a weight-loss program did not confer additional benefits on resting sympathetic nervous activity as assessed from measures of whole-body NE spillover and muscle sympathetic nerve activity, although BP, baroreflex sensitivity and metabolic parameters improved significantly but similarly between the two study groups. 52 These studies demonstrated the importance of insulin resistance and the renin-angiotensin system for weight lossinduced BP reduction associated with aerobic exercise, however, these studies did not compare neurohormonal changes during the acute phase of weight loss.…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, weight loss is recommended as the first-line treatment for obesity. Giving some insight into the possible physiological pathways linking increased morbidity and mortality, elevated sympathetic nervous activity, [36][37][38] insulin resistance 31,32 and stimulation of the renin-angiotensin-aldosterone system 39 are ameliorated after weight loss.…”

Section: Discussionmentioning

confidence: 99%

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

et al. 2011

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The present study compared the effectiveness of a mild calorie-restricted diet (D) alone, exercise (EX) alone and a combination of D+EX on weight loss-induced blood pressure (BP) reduction over 24 weeks. We focussed especially on the relationship between sympathetic nervous activity, as indicated from measures of plasma norepinephrine (NE), and insulin resistance (homeostasis model of insulin resistance, HOMA-IR). The three groups each comprised 30 obese, hypertensive men. Body mass index (BMI), fat mass, waist-to-hip ratio, BP, plasma NE and HOMA-IR were measured every 2 weeks during the first 4 weeks and subsequently every 4 weeks for the next 20 weeks. All basal parameters were similar among the three groups. At 24 weeks, the combination group with D+EX comprised a significantly higher prevalence of normotensive subjects than the D alone or EX alone group (Po0.05). In the D alone group, plasma NE was decreased significantly at 2 weeks, reductions in BMI, fat mass and BP were observed at 8 weeks, and waist-to-hip ratios and HOMA-IR were decreased at 12 weeks. In comparison, in the EX alone group, significant reductions of fat mass and HOMA-IR were observed at 4 weeks. Plasma NE and HOMA-IR were reduced at 8 weeks while decreases in BP were detected at 12 weeks. In the D+EX group, significant reductions in plasma NE were observed at 2 weeks followed by significant decreases in BMI, fat mass, waist-to-hip ratio, BP levels and HOMA-IR at 4 weeks. The magnitudes of reductions of all parameters were greatest in the D+EX group. These results demonstrate that D+EX exerts a stronger ameliorative effect on weight loss, weight loss-induced BP reduction, normalization of BP, sympathetic activation and insulin resistance compared with D or EX alone. D and EX might, perhaps, exert different mechanisms on weight loss and weight loss-induced BP reduction; however, a combination of caloric restriction and exercise is preferred to control BP levels in obese hypertensive patients.

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The Enlarging Effect of Obesity on Estimating Kidney Function: Blaming Serum Creatinine Versus Indexation and Methodology

Kalantar-Zadeh

Tantisattamo

2019

Obesity

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Exercise augments weight loss induced improvement in renal function in obese metabolic syndrome individuals

Abstract: Moderate weight loss in obese MetS patients is associated with a reduction in albuminuria and an improvement in eGFR which is augmented by exercise co-intervention.

Cited by 107 publications

References 51 publications

Effects of weight loss on renal function in overweight Japanese men

Effects of weight loss on renal function in overweight Japanese men

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

The Enlarging Effect of Obesity on Estimating Kidney Function: Blaming Serum Creatinine Versus Indexation and Methodology

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